Another Publication From Our Laboratory

Three-dimensional (3D) printing gained widespread acceptance in many fields of industry and science. Rapid prototyping (RP) technology brought our design to real objects instantly, which allowed us to handle and modify the functional prototypes before production.

Conventional manufacturing processes require complex and time-consuming molding techniques. However, RP and desktop 3D printing allow scientists to see and hold their functional prototypes in a relatively short time. Three-dimensional printing made a quick entrance in medicine, and surgical sciences adapted this technology at the same time with the automotive engineering and aviation fields.

The main applications of 3D printing in the field of surgery include manufacturing of anatomic models based on patient imaging studies, instrument, device, implant production and regenerative medicine. Many studies have been conducted regarding organ models, prosthetics, and surgical implant manufacturing; however, few reports are available related to 3D printing of surgical instruments.

In this study, we aimed to test the possibility of manufacturing 3D printed surgical instruments for use in children. Design time varied for each instrument; Roux retractor was designed in 15 min, and laparoscopic trocar was designed in 2 h. During mechanical stress simulation test, the force per mm2 in laparoscopic trocar resulted in 9.7kgf, and this force which is nearly double the originally applied force caused only 0.84-mm displacement in the instrument. The same force when applied to the Roux retractor’s curved face resulted in 1.1 kgf/mm2 and caused 9.22-mm displacement.

Before manufacturing a surgical instrument from thermoplastic, we knew that it had to face competition with its stainless steel counterparts. This issue was taken into consideration; the designs were modified to be slightly thicker than the conventional stainless steel instruments and were repeatedly tested for mechanical strength in Solidworks Simulation software prior to manufacturing.

The main advantage of the simulation program over the conventional stress tests was the ability to observe the exact weak points of the final product and modify the design accordingly prior to printing. The printing process started after the tests proved that the instruments were resistant to stress. The final products were strong enough to be used as disposable instruments. One of our observations was that printing the part with 100% infill created a more solid and durable instrument.

This issue also increased the reliability of our simulation tests. Conventional stress tests were avoided as we noticed little displacement in the simulation, and intended use was in the field of pediatric surgery in which the surgeons do not apply excessive stress on the instruments. Three-dimensional printing of surgical instruments for children deserves to be studied and developed as it offers the possibility to produce customized and scalable equipment for use in pediatric surgery.